Compression fractures of the spine are common in elderly and osteoporotic patients. They result from anterior or lateral flexion. The typical appearance is loss of height of the anterior aspect of the vertebral body with preservation of the posterior elements and generally the posterior aspect of the vertebral body. On the frontal view, there may be subtle deviation of the paraspinous line due to edema. Differentiation from a pathologic fracture of the spine due to a metastasis is usually of clinical concern, but simple compression fractures are usually due to osteoporosis.

A	Lateral radiograph of the lumbar spine. This shows an osteoporotic compression fracture of the L1 vertebral body.
B	AP radiograph of the lumbar spine. This shows loss of height of the L1 vertebral body, corresponding to a compression fracture.
C	Lateral radiograph of the lumbar spine. This is an image from a different patient and shows a severe compression fracture of the T12 vertebral body.
D	Lateral radiograph of the lumbar spine. Two years prior there was osteopenia, but the fracture was not present.

Links to online textbooks:

• Wheeless' Orthopedics: discussion of compression fractures

Links to online cases:

• Wayne State University

References:

• Barr JD, Barr MS, Lemley TJ, McCann RM: Percutaneous vertebroplasty for pain relief and spinal stabilization Spine. 2000 Apr 15;25(8):923-8.           [See related articles]
• Marczynski W, Kroczak S, Baranski M: Fractures of thoracic and lumbar spine; treatment and follow up Ann Transplant. 1999;4(3-4):46-8.           [See related articles]
• Lane JM, Russell L, Khan SN: Osteoporosis Clin Orthop. 2000 Mar;(372):139-50.           [See related articles]